| NPI | 1861455412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 206315-1) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NY 206315-1) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 206315) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2019-03-05 |